One Dental Specialties

Effective Date: Feb. 1, 2026

THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THIS INFORMATION. PLEASE REVIEW IT CAREFULLY.

Who We Are

One Dental Specialties is a dental and prosthodontic practice located at 621 S. Western Ave. #201, Los Angeles, CA 90005. This notice applies to all protected health information (PHI) created, received, or maintained by our practice.

1. How We Use and Disclose Your Health Information

Treatment: We may share your health information with physicians, specialists, or other providers involved in your care to coordinate and deliver treatment.

Payment: We may use and disclose your health information to process billing and obtain payment from your insurance carrier or other responsible party.

Healthcare Operations: We may use your health information for internal purposes such as quality improvement, staff training, accreditation, and administrative functions necessary to operate our practice.

2. Uses and Disclosures That Do Not Require Your Authorization

In certain situations, we are permitted or required by law to use or disclose your PHI without your written consent. These include public health reporting, abuse or neglect reporting, court orders or legal proceedings, law enforcement requests as required by law, and national security activities as authorized by law.

3. Uses and Disclosures That Require Your Authorization

We will obtain your written authorization before using or disclosing your PHI for purposes beyond treatment, payment, and healthcare operations. This includes the release of psychotherapy notes, use of your information for marketing purposes, and any sale of your PHI. You may revoke your authorization at any time in writing, except where we have already relied on it.

4. New Protections (2024/2026 Updates)

Reproductive Health Care: We are prohibited from disclosing your PHI to investigate or impose liability on any person for seeking, obtaining, or facilitating lawful reproductive health care.

Substance Use Records: Records protected under 42 CFR Part 2 will only be disclosed with your specific written consent or as otherwise permitted by law.

5. Your Rights Regarding Your Health Information

Right to Access: You have the right to inspect and receive copies of your health information. Requests may be submitted in writing. A reasonable fee may apply.

Right to Amend: If you believe your health information is incorrect or incomplete, you may request an amendment. We may deny the request under certain circumstances.

Right to an Accounting of Disclosures: You may request a list of instances in which your PHI was disclosed for purposes other than treatment, payment, or healthcare operations.

Right to Request Restrictions: You may request that we limit how we use or disclose your PHI. We are not required to agree, except when the disclosure is to a health plan for a service you paid for entirely out-of-pocket.

Right to Confidential Communications: You may request that we contact you at a specific phone number or address. We will accommodate reasonable requests.

Right to a Paper Copy of This Notice: You may request a printed copy of this notice at any time, even if you have already received it electronically.

6. Our Responsibilities

We are required by law to maintain the privacy of your PHI, to provide you with this notice, and to notify you in the event of a breach of your unsecured PHI. We will follow the terms of the notice currently in effect and will notify you of any material changes.

7. Complaints

If you believe your privacy rights have been violated, you may file a complaint with us or with the U.S. Department of Health and Human Services Office for Civil Rights. You will not be penalized for filing a complaint.

8. Contact Information

Privacy Officer: Shawn Kim
Telephone: (213) 381-2828
Address: 621 S Western Ave #201, Los Angeles, CA 90005
Email: [Insert contact email]